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Cerebral infarction in eclampsia.

Gerda G Zeeman1, James L Fleckenstein, Diane M Twickler

  • 1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Tex, USA. g.g.zeeman@isala.nl

American Journal of Obstetrics and Gynecology
|March 26, 2004
PubMed
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Neuroimaging reveals that cerebral edema in eclampsia, often reversible vasogenic edema, can progress to cytotoxic edema and infarction in some women. Diffusion-weighted MRI helps characterize these brain lesions.

Area of Science:

  • Neurology
  • Radiology
  • Obstetrics

Background:

  • Eclampsia is a severe complication of pregnancy characterized by seizures.
  • Cerebral edema is a known complication of eclampsia, but its neuroimaging characteristics are not fully understood.

Purpose of the Study:

  • To characterize the neuroimaging findings of cerebral edema in eclamptic seizures using diffusion-weighted magnetic resonance imaging (MRI).

Main Methods:

  • Diffusion-weighted MRI and apparent diffusion coefficient mapping were used to evaluate 27 nulliparous women with eclampsia.
  • Follow-up neuroimaging was performed 6 weeks postpartum for women with findings suggestive of cytotoxic edema.

Main Results:

  • Ninety-three percent of women exhibited reversible vasogenic edema.

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  • Six women also had cytotoxic edema, indicative of cerebral infarction.
  • Five of these six women showed persistent infarction findings postpartum, yet without clinical neurological deficits.
  • Conclusions:

    • The spectrum of cerebral lesions in eclampsia varies.
    • Reversible vasogenic edema can progress to cytotoxic edema and infarction in up to 25% of women.
    • Diffusion-weighted MRI is valuable for assessing these brain lesions.